For our patients undergoing conventional cancer treatment, we want to enhance efficacy of treatment, decrease side effects, address side effects that do arise, help with mental and emotional symptoms often part of that experience, and then, posttreatment, work to help prevent recurrence. Naturopathic and integrative medicine have so much to offer from the worlds of nutrition though food and supplementation, botanical medicine, mindfulness based practices, exercise, and acupuncture. And homeopathy, even in the hands of those less skilled in its use, can be an effective addition to the natural medicine offerings.

The nature of some conventional medical approaches means that we cannot use everything in an integrative tool kit for concern about interfering with chemotherapy or radiation. With homeopathy we do not have that issue; it can be used safely with any other approach without hesitation.

My goals in this article is to give context to homeopathy for cancer patients, address the main places where homeopathy falls short, and offer recommendations on how to address those places, offer specific information about situations and remedies that can be prescribed, and overall, advocate for the use of homeopathy during cancer care.

With homeopathic remedies, we can address specific physical issues related to cancer. For example, I treated a lovely gentleman with metastatic pancreatic cancer. His presenting complaint at our first visit was shortness of breath and difficulty breathing due to the tumor exerting pressure upward onto his lungs. He came in holding a small hand fan and used it throughout our interview. Those who know only rudiments of homeopathic materia medica would recognize the need for the remedy Carbo vegetabilis, which gave him great comfort in his last days by restoring his ability to get a good enough breath.

We can also address acute illnesses that arise during cancer care. Some ailments are run of the mill, such as colds, sore throats, or bladder infections; using indicated homeopathic remedies enables our patients to avoid unnecessary antibiotics or other medications. I recently treated a woman undergoing chemotherapy, whose white count was in the normal range but who nonetheless developed an earache with a high fever and headache. The remedy Belladonna took care of the earache in quick order.

Another important place we can use homeopathy is to address side effects of conventional care. Whether it's helping patients to recover faster and better from surgery or to address GI complaints associated with chemotherapy or dermatological issues that arise during radiation, homeopathy alongside other natural medicine approaches has our patients better able to handle the onslaught that is conventional medical cancer care.

And this matters because it's generally understood that outcomes improve if patients take all recommended chemotherapy or radiation in a specified amount of time. Mounting or worsening side effects can delay or halt treatments. So, while most patients do have some side effects, we want to prolong the amount of time before side effects begin and the severity of those side effects with the hope of enabling our patients to complete conventional care in a timely and recommended fashion. Natural medicines, including homeopathy, help delay the onset of side effects. I discuss many of the remedies we think about for addressing side effects below.

Homeopathy is also a premier approach to working with the mental and emotional issues that patients have during conventional cancer care. For many it's a shock to receive a cancer diagnosis; for some it's devastating. Those with a medical history that includes anxiety or depression will often be triggered. And even those without such a history may need support in this realm, and a homeopathic remedy can be pointed specifically to how the patient experiences their anxiety, depression, or irritability. I recall a cancer patient in my care who felt that the anxiety was actually the worst part of his whole diagnosis and times of treatment. The inability to make plans, the sheer number of doctor appointments, the lab work, the scans, each step of the way, there was ample opportunity to become anxious, and he did! Add to that his intractable insomnia and chronic loose stools, and we find the homeopathic remedy Arsenicum album, which helped him face his treatments with renewed energy and optimism and got him away from his "what if?" ledge.

Homeopathy is cost effective and has no side effect profile. Compliance is high; after all, it tastes like candy! Sadly, I have also had wide experience treating pediatric cancer patients, and homeopathy has been immensely helpful to them and their families throughout treatment.

In addition, I value homeopathy and use it with most every patient I treat, with cancer or otherwise, because at its core, it's both holistic and vitalistic. Many of us found naturopathic or integrative medicine as we were drawn by the ideas of holism and vitalism, yet our tools are increasingly reductionist, focused on minutiae of specific biochemical reactions, and thereby mechanistic. Not that such tools are unimportant or do not work (and believe me, as a breast and ovarian cancer survivor/thriver myself, I employ them all on myself and with my patients!). But I also draw tremendous satisfaction and positive clinical results when I can look at the whole patient and find a medicine that addresses physical, cognitive, and emotional aspect of my patients. Likewise, working with a modality that stimulates the patient's innate healing ability is in synch with how I understand people, nature, and healing. Lastly, the homeopathic interview, the process of gathering information to make a prescription, is itself healing for both doctor and patient. For the doctor because it allows us to connect with our patient in loving and meaningful ways, and the patient who in turn feels heard and supported.

But homeopathy often falls short. If not aware, the prescriber does not know enough to differentiate between a seemingly acute situation or one wherein the patient needs their constitutional remedy instead. If the prescriber is ableto determine that it's a true acute situation, there can be trouble knowing where and how to focus the case. Lastly, for some prescribers, there can be a feeling of overwhelm when a patient's symptoms are across many systems of the body and also include emotional or cognitive challenges. When and if a homeopathic remedy is given, there are additional challenges: the remedy does nothing, the remedy does a little something, but not much, or the remedy works well, but wears off quickly.

Let's take up each of these challenges one by one. As background, Paul Herscu, ND, MPH, my longtime husband and collaborator, has articulated a helpful way to look at our patients. The underlying concept of stress and strain pertains. We are each susceptible to events and exposures in our environment based on our genetic inheritance and lifestyle kinds of choices that we have made through a lifetime. The same kind of emotional or environmental insult does not have the same impact on every person.

There are typically many stressors to which we are responding at any given time.

I would also offer that we respond to stressors in predictable and patterned ways according to our underlying homeopathic constitutional state.

So for some patients, the stress of chemotherapy (and by that I mean the overall impact, not just the emotional stress) will push the person in a way that they are accustomed to being pushed. I recall a patient of mine who was a migraine sufferer. During radiation treatments for breast cancer, her migraines were triggered. Her constitutional remedy, which had been helpful before to reduce the number, severity, and duration of migraines, was once again helpful. Another patient, with a long history of insomnia, during chemotherapy for colon cancer found sleep almost impossible. He was offered many pharmaceutical sleep aids but instead remembered that homeopathy had helped him sleep. So while we worked with many of the naturopathic approaches to prevent typical side effects from chemotherapy, he also got essential help for his sleep with his constitutional remedy.

That said, sometimes, when the stress is strong enough or different enough for a particular patient, or takes place over a long period of time, the patient is pushed out of their constitutional state and instead needs an acute remedy to address the acute situation that has arisen. For example, for one of my patients, during radiation treatment for breast cancer, her skin began to break down in the treated area. The kind of pain and discomfort experienced was not covered by the patient's usual constitutional remedy. She also had a notable temperamental shift. In this case, I looked for an acute remedy to help. Further along in this article, I describe acute remedies for common issues that arise during conventional cancer care, but first and foremost it is important to know that sometimes a patient will respond best to their constitutional remedy even if the presenting symptom/side effect/ issue seems to be acute. This is the place where I find that most colleagues make a mistake or find that homeopathy does not work; it's because they are not focusing the remedy on the correct aspect of the patient.

With regard to case taking, it is not different than with any other patient. I work to find a remedy for the whole person by trying to understand the physical manifestations, the modalities, or things that make the symptoms better or worse. I try to understand the quality of discomfort and if there are any concomitant symptoms. I want to know what is most limiting to the patient at the time of the visit while I work to understand symptoms in context of the patient's life. I always ask for examples of symptoms reported and try not to not take anything at face value. I am observant and let my observations inform my intake questions. I aim to get a sense of the person I am working with, not just the symptom(s) that they have. Most importantly, I need a clear sense of what I am trying to help.

For those working with more constitutional homeopathy, it's good to remember that sometimes we see a relationship between constitutional and acute remedies. For example a person needing the constitutional remedy Natrum muriaticum may go into Bryonia acute illnesses. Similarly, Calcarea carbonica may go into Belladonna acutes, Sulphur may go into Arsenicum album acutes, and Nux vomica may go into Ignatia acutes. It's also good to think outside the box. Some remedies that are commonly thought of for treating acute conditions such as Aconite and Arnica can be given as constitutional remedies, and other remedies that are usually thought of more constitutionally can be used acutely like Tuberculinum and Medorrhinum.
Prehab has long been accepted as essential before orthopedic or cardiovascular procedures or surgeries. Increasingly and for good reason, prehab is now being both studied and recommended in the world of oncology. Most cancer patients have some weeks postdiagnosis before treatments begin. Prehab includes offerings or referring for smoking cessation programs, physical therapy, general exercise, psychosocial assessment/stress reduction techniques, and nutrition counseling. Prehab with homeopathy would be offering the patient his or her constitutional remedy to help them be in as good a shape as possible in advance of treatment.

We will review top remedy differentials for commonly occurring conditions or side effects related to conventional cancer care, including postsurgery, chemotherapy, radiation, impact of other drugs, anxiety and depression, and posttreatment. To reiterate, these are some of the remedies to think of if the patient does not need their constitutional remedy. The following are the remedies that I have found most helpful for these conditions; your medicines may vary. It is helpful to study differential lists as you will better learn the various types of pain or discomfort, modalities, and etiologies associated with acute illness and the relevant remedies to help. Many of these differentials are the same as they would be for similar symptom presentations for patients not undergoing treatment for cancer; the indications remain the same and apply.

Before surgery I do not routinely offer a remedy unless my patient is especially anxious. The remedies I think about for the very anxious and their indications are:Aconite: There are waves of panic with sudden, intense fear. The patient is agitated and restless, and may believe they are about to die due to the surgery. They have dry skin and dry mouth with strong thirst and a pounding heart.Arsenicum album: There is anxiety with loose stool, chilliness, the patient needs a lot of attention and encouragement; there may be nausea with loose stools.Gelsemium: Thepatient feels paralyzed by the anxiety, and there may be weakness and trembling.

After surgery:Arnica: This remedy, barring any other symptoms, I will give routinely post surgery to reduce swelling and promote healing. We use especially if the patient describes soreness and is worse from jarring. The patient feels as if they've been beat up and bruised. Arnica is also useful if a hematoma is present.Aconite: We think of when fear is the main issue, shock and fright after surgery, panic attacks that began postsurgery, even many months later. Bryonia: Use this remedy when the patient has strong pain and is dry, thirsty, irritable, and worse from any movement; that can be their own movement or the movement of the bed, say from sitting on the edge of the bed.Nux vomica: Those needing this remedytend to be bossy and controlling of their environment. Additionally, they are usually constipated with an ineffectual urge, chilly and cannot get warm, often with abdominal cramps after surgery, regardless of the operation. Mag phos: Think of this remedy when there are strong cramping pains, better with heat.Staphysagria: This patient feels as if they are getting stabbed at area of incision; the wound is sensitive and angry looking. Pain lasts long after the surgery, even months.Opium: There will be pain with sleepiness, dullness, snoring respiration and stupor; the patient does not wake well from anesthesia. There may be paralysis of bladder postsurgery. The patient may also have ongoing fright a long time afterward, whenever they think of the surgery.Chamomilla: You can find tremendous irritability and oversensitivity postsurgery, cannot bear to be examined, also generally difficult to please.Causticum: Use when the patient is unable to urinate postsurgery; also rule out Opium.